Individual provider Active NPI

Collette Marie Fearneyhough, PNP

  • Pediatric Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1477516763
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP8810 Issued in CA
Practice address
1625 Stockton Blvd
#106
Sacramento, CA 95816
Phone
(916) 262-9002
Fax
(916) 269-9012
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP8810 CA Primary

Addresses

Primary practice location

1625 Stockton Blvd
#106
Sacramento, CA 95816

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP8810CAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cfearneyhoughnp27692@hisp.ehr.sutterhealth.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1477516763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STOCKTON BLVD",
            "address_2": "#106",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95816",
            "telephone_number": "916-262-9002",
            "fax_number": "916-269-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARNEYHOUGH",
        "first_name": "COLLETTE",
        "middle_name": "MARIE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP8810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.